Efficacy of folic acid therapy in primary prevention of stroke among adults with hypertension in China: the CSPPT randomized clinical trial.
Yong Huo,Jianping Li,Xianhui Qin,Xianhui Qin,Yining Huang,Xiaobin Wang,Rebecca F. Gottesman,Rebecca F. Gottesman,Genfu Tang,Binyan Wang,Binyan Wang,Dafang Chen,Mingli He,Jia Fu,Yefeng Cai,Xiuli Shi,Yan Zhang,Yimin Cui,Ningling Sun,Xiaoying Li,Xiaoshu Cheng,Jian’an Wang,Xinchun Yang,Tianlun Yang,Chuanshi Xiao,Gang Zhao,Qiang Dong,Dingliang Zhu,Xian Wang,Junbo Ge,Lianyou Zhao,Dayi Hu,Lisheng Liu,Fan Fan Hou +33 more
TLDR
Among adults with hypertension in China without a history of stroke or MI, the combined use of enalapril and folic acid, compared with en alapril alone, significantly reduced the risk of first stroke.Abstract:
Importance Uncertainty remains about the efficacy of folic acid therapy for the primary prevention of stroke because of limited and inconsistent data. Objective To test the primary hypothesis that therapy with enalapril and folic acid is more effective in reducing first stroke than enalapril alone among Chinese adults with hypertension. Design, Setting, and Participants The China Stroke Primary Prevention Trial, a randomized, double-blind clinical trial conducted from May 19, 2008, to August 24, 2013, in 32 communities in Jiangsu and Anhui provinces in China. A total of 20 702 adults with hypertension without history of stroke or myocardial infarction (MI) participated in the study. Interventions Eligible participants, stratified by MTHFR C677T genotypes (CC, CT, and TT), were randomly assigned to receive double-blind daily treatment with a single-pill combination containing enalapril, 10 mg, and folic acid, 0.8 mg (n = 10 348) or a tablet containing enalapril, 10 mg, alone (n = 10 354). Main Outcomes and Measures The primary outcome was first stroke. Secondary outcomes included first ischemic stroke; first hemorrhagic stroke; MI; a composite of cardiovascular events consisting of cardiovascular death, MI, and stroke; and all-cause death. Results During a median treatment duration of 4.5 years, compared with the enalapril alone group, the enalapril–folic acid group had a significant risk reduction in first stroke (2.7% of participants in the enalapril–folic acid group vs 3.4% in the enalapril alone group; hazard ratio [HR], 0.79; 95% CI, 0.68-0.93), first ischemic stroke (2.2% with enalapril–folic acid vs 2.8% with enalapril alone; HR, 0.76; 95% CI, 0.64-0.91), and composite cardiovascular events consisting of cardiovascular death, MI, and stroke (3.1% with enalapril–folic acid vs 3.9% with enalapril alone; HR, 0.80; 95% CI, 0.69-0.92). The risks of hemorrhagic stroke (HR, 0.93; 95% CI, 0.65-1.34), MI (HR, 1.04; 95% CI, 0.60-1.82), and all-cause deaths (HR, 0.94; 95% CI, 0.81-1.10) did not differ significantly between the 2 treatment groups. There were no significant differences between the 2 treatment groups in the frequencies of adverse events. Conclusions and Relevance Among adults with hypertension in China without a history of stroke or MI, the combined use of enalapril and folic acid, compared with enalapril alone, significantly reduced the risk of first stroke. These findings are consistent with benefits from folate use among adults with hypertension and low baseline folate levels. Trial Registration clinicaltrials.gov Identifier:NCT00794885read more
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Heart Disease and Stroke Statistics—2017 Update: A Report From the American Heart Association
Emelia J. Benjamin,Michael J. Blaha,Stephanie E. Chiuve,Mary Cushman,Sandeep R Das,Rajat Deo,Sarah D. de Ferranti,James S. Floyd,Myriam Fornage,Cathleen Gillespie,Carmen R. Isasi,Monik C. Jim'nez,Lori Chaffn Jordan,Suzanne E. Judd,Daniel T. Lackland,Judith H. Lichtman,Lynda D. Lisabeth,Simin Liu,Chris T. Longenecker,Rachel H. Mackey,Kunihiro Matsushita,Dariush Mozaffarian,Michael E. Mussolino,Khurram Nasir,Robert W. Neumar,Latha Palaniappan,Dilip K. Pandey,Ravi R. Thiagarajan,Mathew J. Reeves,Matthew D. Ritchey,Carlos J. Rodriguez,Gregory A. Roth,Wayne D. Rosamond,Comilla Sasson,Amytis Towfghi,Connie W. Tsao,Melanie B. Turner,Salim S. Virani,Jenifer H. Voeks,Joshua Z. Willey,John T. Wilkins,Jason H Y Wu,Heather M. Alger,Sally S. Wong,Paul Muntner +44 more
TL;DR: WRITING GROUP MEMBERS Emelia J. Benjamin, MD, SCM, FAHA Michael J. Reeves, PhD Matthew Ritchey, PT, DPT, OCS, MPH Carlos J. Jiménez, ScD, SM Lori Chaffin Jordan,MD, PhD Suzanne E. Judd, PhD
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Heart Disease and Stroke Statistics—2019 Update: A Report From the American Heart Association
Emelia J. Benjamin,Paul Muntner,Alvaro Alonso,Márcio Sommer Bittencourt,Clifton W. Callaway,April P. Carson,Alanna M. Chamberlain,Alex R. Chang,Susan Cheng,Sandeep R Das,Francesca N. Delling,Luc Djoussé,Mitchell S.V. Elkind,Jane F. Ferguson,Myriam Fornage,Lori C. Jordan,Sadiya S. Khan,Brett M. Kissela,Kristen L. Knutson,Tak W. Kwan,Daniel T. Lackland,Tené T. Lewis,Judith H. Lichtman,Chris T. Longenecker,Matthew Shane Loop,Pamela L. Lutsey,Seth S. Martin,Kunihiro Matsushita,Andrew E. Moran,Michael E. Mussolino,Martin O'Flaherty,Ambarish Pandey,Amanda M. Perak,Wayne D. Rosamond,Gregory A. Roth,Uchechukwu K.A. Sampson,Gary Satou,Emily B. Schroeder,Svati H. Shah,Nicole L. Spartano,Andrew Stokes,David L. Tirschwell,Connie W. Tsao,Mintu P. Turakhia,Lisa B. VanWagner,John T. Wilkins,Sally S. Wong,Salim S. Virani +47 more
TL;DR: March 5, 2019 e1 WRITING GROUP MEMBERS Emelia J. Virani, MD, PhD, FAHA, Chair Elect On behalf of the American Heart Association Council on Epidemiology and Prevention Statistics Committee and Stroke Statistics Subcommittee.
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Heart Disease and Stroke Statistics-2018 Update: A Report From the American Heart Association.
Emelia J. Benjamin,Salim S. Virani,Clifton W. Callaway,Alanna M. Chamberlain,Alex R. Chang,Susan Cheng,Stephanie E. Chiuve,Mary Cushman,Francesca N. Delling,Rajat Deo,Sarah D. de Ferranti,Jane F. Ferguson,Myriam Fornage,Cathleen Gillespie,Carmen R. Isasi,Monik C. Jiménez,Lori C. Jordan,Suzanne E. Judd,Daniel T. Lackland,Judith H. Lichtman,Lynda D. Lisabeth,Simin Liu,Chris T. Longenecker,Pamela L. Lutsey,Jason Mackey,David B. Matchar,Kunihiro Matsushita,Michael E. Mussolino,Khurram Nasir,Martin O'Flaherty,Latha Palaniappan,Ambarish Pandey,Dilip K. Pandey,Mathew J. Reeves,Matthew D. Ritchey,Carlos J. Rodriguez,Gregory A. Roth,Wayne D. Rosamond,Uchechukwu K.A. Sampson,Gary Satou,Svati H. Shah,Nicole L. Spartano,David L. Tirschwell,Connie W. Tsao,Jenifer H. Voeks,Joshua Z. Willey,John T. Wilkins,Jason H Y Wu,Heather M. Alger,Sally S. Wong,Paul Muntner +50 more
TL;DR: The Statistical Update represents the most up-to-date statistics related to heart disease, stroke, and the cardiovascular risk factors listed in the AHA's My Life Check - Life’s Simple 7, which include core health behaviors and health factors that contribute to cardiovascular health.
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Heart Disease and Stroke Statistics—2020 Update: A Report From the American Heart Association
Salim S. Virani,Alvaro Alonso,Emelia J. Benjamin,Márcio Sommer Bittencourt,Clifton W. Callaway,April P. Carson,Alanna M. Chamberlain,Alex R. Chang,Susan Cheng,Francesca N. Delling,Luc Djoussé,Mitchell S.V. Elkind,Jane F. Ferguson,Myriam Fornage,Sadiya S. Khan,Brett M. Kissela,Kristen L. Knutson,Tak W. Kwan,Daniel T. Lackland,Tené T. Lewis,Judith H. Lichtman,Chris T. Longenecker,Matthew Shane Loop,Pamela L. Lutsey,Seth S. Martin,Kunihiro Matsushita,Andrew E. Moran,Michael E. Mussolino,Amanda M. Perak,Wayne D. Rosamond,Gregory A. Roth,Uchechukwu K.A. Sampson,Gary Satou,Emily B. Schroeder,Svati H. Shah,Christina M. Shay,Nicole L. Spartano,Andrew Stokes,David L. Tirschwell,Lisa B. VanWagner,Connie W. Tsao +40 more
TL;DR: This year's edition of the Statistical Update includes data on the monitoring and benefits of cardiovascular health in the population, metrics to assess and monitor healthy diets, an enhanced focus on social determinants of health, a focus on the global burden of cardiovascular disease, and further evidence-based approaches to changing behaviors, implementation strategies, and implications of the American Heart Association’s 2020 Impact Goals.
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TL;DR: The American Heart Association, in conjunction with the National Institutes of Health, annually reports the most up-to-date statistics related to heart disease, stroke, and cardiovascul...
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